Functional ovarian hyperandrogenism and polycystic ovary syndrome in prepubertal girls with obesity and/or premature pubarche

Aims: Functional ovarian hyperandrogenism (FOH) is considered to be a form of polycystic ovary syndrome (PCOS) at adolescence. There are almost no data in the prepubertal period, although one of the earliest manifestations of PCOS is premature pubarche. Prepubertal girls with obesity or insulin resistance are also at risk to develop the full PCOS phenotype after puberty. The aim of this study was to evaluate prepubertal girls with premature pubarche and/or obesity for PCOS or FOH. Methods: Twenty-seven prepubertal girls with premature pubarche and/or obesity aged > 6 years were evaluated. FOH was defined as abnormal ovarian 170HP response to challenge with GnRH analog of > 2 ng/ml after exclusion of adrenal dysfunction. All patients underwent a pelvic ultrasound examination. Results: Sixteen patients had premature pubarche, seven were obese, and four had both premature pubarche and obesity. Eleven of 27 patients (40.7%) showed high (> 2 ng/ml) 170HP response to GnRH challenge. Three patients (11%) with FOH also showed PCO morphology on pelvic ultrasound examination. Conclusion: In prepubertal girls who carry risk. factors, including genetic polymorphisms and/or particular environmental factors, FOH/PCOS could develop at a high rate.